Gómez Díaz Oswaldo J, Cruz Sánchez Mario D
Division of Plastic Surgery, Department of Surgery, School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia.
Plast Reconstr Surg Glob Open. 2016 Dec 27;4(12):e1165. doi: 10.1097/GOX.0000000000001165. eCollection 2016 Dec.
The retroauricular tissues have been used for a long time for ear reconstruction, but the anatomical bases of flaps of this region are not completely clear. The aim of this study was to estimate blood supply area and location of this on the skin and fascia retroauricular dependent of posterior auricular artery (PAA) to establish safe margins to design flaps for auricular reconstruction.
Dissection under magnification (×3.5) of the PAA through a cervical approach; injection of methylmethacrylate in the PAA as a staining technique; retroauricular approach to identify the territory of irrigation of PAA in the retroauricular skin and fascia; measuring and location of the stained area; and report of 2 cases of ear reconstruction with fasciocutaneous and fascia flaps based on PAA, designed according to the anatomical study.
In a sample of 10 cadaveric specimens, the PAA irrigated an area of the retroauricular skin and fascia of 10.7 cm length × 7.07 cm wide equivalent to 60.44 cm (95% CI, 37.07-83.81), with a distribution posterior to external auditory canal of 7.15 cm (95% CI, 5.53-8.77) and posterior to the helix insertion of 6.12 cm (95% CI, 4.89-7.35). In the 2 patients treated with fascia and fasciocutaneous flaps based on the PAA, these were good options for ear reconstruction.
A fascia or fasciocutaneous flap from the retroauricular region based on PAA within the dimensions and location found in this study will be a safe option for reconstruction of the ear.
耳后组织长期以来一直用于耳部重建，但该区域皮瓣的解剖学基础尚不完全清楚。本研究的目的是评估耳后动脉（PAA）供血区域及其在耳后皮肤和筋膜上的位置，以确定安全边界，为耳部重建设计皮瓣。
通过颈部入路在放大3.5倍的情况下解剖PAA；向PAA内注射甲基丙烯酸甲酯作为染色技术；采用耳后入路确定PAA在耳后皮肤和筋膜的灌注区域；测量并定位染色区域；并报告2例根据解剖学研究设计的基于PAA的筋膜皮瓣和筋膜瓣耳部重建病例。
在10个尸体标本样本中，PAA供血的耳后皮肤和筋膜区域长10.7厘米、宽7.07厘米，面积相当于60.44平方厘米（95%可信区间，37.07 - 83.81），外耳道后方的分布长度为7.15厘米（95%可信区间，5.53 - 8.77），耳轮插入点后方的长度为6.12厘米（95%可信区间，4.89 - 7.35）。在2例接受基于PAA的筋膜瓣和筋膜皮瓣治疗的患者中，这些皮瓣是耳部重建的良好选择。
基于本研究中发现的尺寸和位置，采用耳后区域基于PAA的筋膜瓣或筋膜皮瓣进行耳部重建将是一种安全的选择。
